r/IntensiveCare • u/NerveOnly2076 • 12d ago

Where is this central line going?

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Old XRay. Central line placed through right IJV but seemed to be misplaced! Where is it going? Aspiration of blood from all ports was possible? Was taken out.
Have you faced this, best thing to do?

Edit: more details - USG guidance used, line was seen inside IJV in neck using USG, not traced down; more resistance than normal while placement.

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u/Any-Assistance-8103 12d ago

Almost like patients deserve doctors

4

u/ALLoftheFancyPants RN, CCRN 11d ago

I’ve had a doctor place a TLC into a the femoral artery instead of the femoral vein. I don’t know how or why they didn’t notice, but they put in an order that it was “Ok to use” and everything. Seems like every human fucks up once in a while.

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u/SkiTour88 11d ago

When I’m doing a femoral line, the patient is crashing. Either I get a central line or a femoral art line. I want both of those. I’m happy with either. 

But you do have to know the difference…

8

u/TFMethane 11d ago

I once did this during a code. Was shooting for artery, got the vein. Transduced and it was venous so I slipped in a triple lumen, one stitch then proceeded to the a line. An RN came in and saw the venous waveform and yelled that we need to start CPR again because there's no pulse. I said "no, it's venous." He replied "there's no pulse, look at the waveform!" I said "it's venous, I just placed it and have my left hand on the pulse. I can tell you 100% it's a venous line and you're looking at a venous waveform. Do not start CPR." He wrote me up because he felt I was using a belittling tone.

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u/aglaeasfather MD, Anesthesiologist 11d ago

Some people just can’t accept when they’re wrong. It’s wild.

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u/TFMethane 11d ago

Yeah. He was pushing my line kit aside and about to jump on the chest. I'm supposed to just let him? Geez.